Bilateral Tumor Infiltration of the Optic Nerve in a Patient with Acute Lymphoblastic Leukemia (ALL) with Central Nervous System (CNS) Involvement: Case Report

Leukemic infiltration of the optic nerve is a rare but serious manifestation of acute lymphoblastic leukemia (ALL), particularly when involving the central nervous system (CNS). We report the case of a 23-year-old woman with a history of ALL in remission who presented with binocular diplopia, vertigo, and a central scotoma. Ophthalmic examination revealed bilateral optic disc edema, and cerebrospinal fluid analysis confirmed CNS relapse. The patient underwent intrathecal chemotherapy with subsequent improvement in visual function and reduction of optic nerve infiltration. This case underscores the importance of prompt recognition of visual symptoms in ALL survivors, as they may signal CNS involvement requiring urgent intervention.